June 22, 2021
There is no single solution to address the opioid crisis, but one thing is clear: Naloxone saves lives in emergencies. Expanding access to opioid overdose reversal medications like naloxone is one critical component of a broader strategy needed to combat increasing accidental overdoses in New York, and Gov. Andrew Cuomo has it on his desk to do so.
The U.S. Centers for Disease Control and Prevention reported nearly 90,000 drug overdose deaths in the 12-month period ending in October 2020 — the largest number for a 12-month period ever recorded. In New York alone, at least 20 counties and New York City have recorded overdose increases since the pandemic began, including my home county of Erie.
We know co-prescribing policies work to increase access to naloxone for those at risk of an overdose. The New Mexico Department of Health reported in late 2020 that prescription opioid overdose deaths decreased statewide in 2019 when more than 94,000 doses of naloxone were dispensed or distributed, representing an increase of 95 percent from 2018. This increase in naloxone distribution correlated with the passage of SB 221, which required health care providers to co-prescribe naloxone when the patient is prescribed more than a four-day supply of opioids.
A co-prescription policy would also help to reduce the stigma that persists among those who are prescribed opioids and remain at risk. I still clearly recall one of my former patients — we were going through her medication history and without hesitation, she listed off her daily routine of antihypertensive drugs, but when she reached suboxone (buprenorphine and naloxone), she put her head down in front of the nurse and me in the closed room, as if ashamed. It’s just one example of the sensitivities many patients feel when discussing their treatment and care. Just like an overdose, it is an internal stigma that requires approaches from different angles to address. This legislation would empower health care professionals to equip at-risk patients with the potentially lifesaving medication in a safe environment, further increasing opportunities for patient-physician conversations around naloxone and the risk of overdose.
Just this April, New Jersey Gov. Phil Murphy signed co-prescribing legislation into law. What New Jersey and 10 other states have done is successfully put into place guardrails that respect the potential harms of opioids and empower prescribers to educate their patients about their risk of overdose and equip them with naloxone.
New York must follow suit, immediately.
Dr. Joshua Lynch is an emergency physician and EMS medical director from Buffalo, and the founder and medical director of New York MATTERS.